New Hanover County:
- Increase the percentage of adults who are neither overweight nor obese.
- Reduce excessive drinking rates/alcohol-related traffic crashes
- Reduce unintentional poisoning death rate for prescription drugs and opioid use
2016 State of the County Health Report
- Chronic diseases, including diabetes, cancer, and hypertension
- Substance Abuse/Mental Health broadly to include drugs, alcohol, smoking, access to mental health services
- Injury/accidental death
Brunswick County Health Assessment
- Identify available resources for mental health and substance abuse prevention and increase awareness among Pender County residents.
- Identify available resources for diabetes prevention and care and increase awareness among Pender County residents
- Increase public awareness and promote opportunities for increasing physical activity.
- Survey of Pender County Residents in indicated Alcohol, Drug and Medication Abuse, Low Income/Poverty and Child Abuse/Neglect as the top issues affecting health in the county.
2018 Pender County Health Assessment
2016 State of the County Health Report
New Hanover County:
- Mobile Food Market: Several government and community partners have begun discussions regarding a mobile market in the area. This need has developed in response to increasing access to healthy food options in areas where there are limited healthy options.
- Minority Diabetes Prevalence: A regional grant has been presented to address the growing rate of prediabetes in minority communities. An estimated 2.5 million North Carolinians are living with prediabetes and without intervention, 11% of those would go on to develop diabetes. The Office of Minority Health and Health Disparities is providing the grant to communities that plan to reach African American, Native American, Asian and Hispanic communities.
State of the County Health Report Reference
- Hepatitis C (HCV) is a bloodborne pathogen that is on the rise due to shared needles and the heroin epidemic. In 2016, Brunswick County had the 2nd highest number of acute hepatitis C cases in the state of North Carolina. Reported cases have doubled from 2015-2016 and are six times higher since 2012. Cases are often underreported and underestimated.
State of the County Health Report Reference
North Carolina Medicaid Transformation - In 2018, North Carolina will request proposals from
the Health Insurance Marketplace as the Medicaid program moves toward a managed care
system. Medicaid revenue streams into the health departments face uncertainties. Health
departments will remain as essential providers and the Managed Care Organizations will seek
contracts with the health departments. The Pender County Health Department must be
prepared to implement new ways of doing business in the future which will include addressing
the social determinants of health.
- Behavioral Health Needs - There is an inadequate workforce to deliver effective outpatient
behavioral health programs. Currently, there is an overuse of the Emergency Department to
provide urgent assessments and care. The inclusion of behavioral health services covered by
health insurance means people have greater access to help they need. People see their
primary care provider more often than a specialist. The integration of behavioral health into
primary care can help address concerns more quickly. Primary care providers are encouraged
to look at the whole health of their patients. As Medicaid Transformation becomes a reality, the
health department must position itself as a fully integrated health care provider that offers
physical and behavioral health care services.
- Senior Population - Retirement of the Baby Boomer Generation has begun and by 2030 this
boomer retirement will nearly double the number of Social Security and Medicare recipients.
Pender County will have more residents over the age of 65 years than under the age of 17.
This change in demographics will present many challenges as well as opportunities. Health
care practices and services will need to change and long-range planning should begin to
prepare for new ways of caring for our residents.
- Aging Public Health Workforce - The nation’s entire public health workforce is aging. The
average public health worker is 47 years old, seven years older than the rest of the nation’s
workforce. Without developing succession plans, the health department will lack the expertise
and capacity needed to fill this void. Public health continues to expand in areas such as
community outreach, public health preparedness and issues related to the aging population. An
emphasis needs to be placed on preparing future public health workers in order to meet the
emerging challenges in the coming years.
2017 State of the County Health Report Reference
2016 tate of the County Health Report Reference
New Hanover County:
- Parks Prescription: Parks Prescriptions: Park prescriptions is a movement to strengthen the connection between health care and parks and public lands to improve the physical and mental health among individuals and communities. The New Hanover County Health Department will work with the New Hanover County Parks Department and the SEAHEC Agency to implement park prescriptions programs throughout the county.
- Violence Prevention as a Public Health Issue: The Blue Ribbon Commission for the Prevention of Youth Violence is researching ways to partner with Public Health to address community violence. BRC representatives are exploring community health worker models that have been successful in other states.
- School Health Advisory Council: The New Hanover County SHAC is proposing wellness coordinators be enlisted at every school to support the schools newly amended wellness policy. The SHAC executive committee is hoping to have a group of interested professionals trained to deliver programming to students, staff and parents in every school.
- Faithful Families Eating Smart Moving More: The NHCHD is working with regional partners to deliver the FFESMM program to area churches. This evidenced based program is designed to engage faith-based communities in fitness and nutrition programs that lead to positive health outcomes.
- Be Active Kids Curriculum: Smart Start of New Hanover County staff are working to train the trainer to deliver action-based content in child care settings.
- Farm to School Initiative: Smart Start has the opportunity to participate in a farm to school team building activity. NHC was chosen to convene a team to work together to develop a farm to school network in the county.
- New Hanover County Food Policy Council: Several community groups have convened to lay plans to form a food policy council in NHC. The primary purpose of is to synthesize information and coordinate efforts to advise elected officials and public administrators about how they can further support our local food system.
- Booze it or Loose It Media Campaign: The NHCHD is working to increase public awareness of DWI checking stations by partnering with the Forensic Tests for Alcohol Branch using the Booze it or Loose it Campaign. "Booze It & Lose It" was launched in 1994 to increase awareness of the dangers of drinking and driving, as well as the penalties associated with driving drunk.
- American Ninja Warrior"- style challenge courses at area parks: The parks and gardens department is in talks with various community partners to support an interactive obstacle course at one or more of their parks. The goal would be to get the community engaged in a competitive style activity outdoors.
- ENGAGE SENC: The Engage Southeast North Carolina Community platform (EngageSENC.org) is a new web-based tool to help scholars, educators, organizations, community members, decision makers, and philanthropic funders in Columbus, Brunswick, New Hanover, Pender and Onslow County cross boundaries and collaborate on projects to improve the quality of life in Southeastern North Carolina.
NHC Health Assessment
NHC State of the County Health Report
- Medication Disposal: BCHS partners with the Brunswick County Sheriff’s Office to encourage residents to protect their families by using the secure collection drop-boxes located at several Sheriff’s Office and police department locations.
- Controlled Substance Reporting System: Brunswick County Health Services (BCHS) promotes the Controlled Substance Reporting System, which is a database for prescription providers to share patient information to assist in identifying and preventing the misuse of controlled substances. BCHS is creating an updated provider contact list to identify CSRS users in the county. BCHS staff will contact providers and pharmacies to determine if they are registered on CSRS. They will also provide resources to assist offices and pharmacies with the registration process.
- Naloxone Kit Distribution: Brunswick County law enforcement and EMS currently carry Naloxone, which is the reversal agent for heroin and other opioid overdoses. One of our community partners, Coastal Horizons, distributes Naloxone kits to their clients, as well as friends and families of individuals who may be at risk of an overdose.
- The Care Coordination for Children (CC4C) program, through Brunswick County Health Services, serves children from birth to age 5 in high-risk situations. CC4C program staff distribute medication lock boxes to families who keep medications in their home. Utilizing lock boxes for medication storage prevents children from accessing these medications and reduces their risk of accidental overdose. Learn more on page 5 of the State of the County Health Report.
- Diabetes Prevention and Education Interventions has been implemented by BCHS to at-risk populations. Their goal is to decrease the number of adults with diabetes and improve the dietary habits of residents. BCHS hosts the Diabetes Self Management Education (DSME) Program, which is approved by the American Diabetes Association. The DSME Program provides education to help individuals manage their type 2 diabetes, prevent complications, and develop healthy lifestyle habits. We partner with Cooperative Extension to provide several community-based programs. Cooperative Extension facilitates Faithful Families, and the Expanded Food and Nutrition Education Program (EFNEP) to teach individuals about smart shopping, healthy eating, and the benefits of physical activity.
- Dosher Memorial Hospital, a community partner, received the Healthy People Healthy Carolinas (HPHC) grant from the Duke Endowment to implement evidence-based interventions that address chronic disease, nutrition and/or physical activity over the next three years. With this funding, the Brunswick Wellness Coalition (BWC) was formed with representatives from Brunswick County Health Services, Dosher Memorial Hospital, New Hope Clinic, YMCA, and additional organization representatives. BWC aims to improve the County Health Ranking Health Outcomes score, decrease the obesity rate, decrease physical inactivity levels, and decrease the diabetes age-adjusted death rate. Learn more on page 6 of the State of County Health Report.
- Booze It and Lose It: Increasing awareness of the dangers and penalties associated with drinking and driving, as well as high visibility enforcement, will decrease the instance of alcohol-related crashes and deaths in Brunswick County.
- Click It or Ticket: Increasing awareness of the importance of proper seat belt use for drivers and occupants, as well as high visibility enforcement, will increase seat belt use in Brunswick County. *High Visibility Enforcement (HVE) is a universal traffic safety approach designed to create deterrence and change unlawful traffic behaviors.*
- Street Safe Driving Safety Education Program for teens that also provides an alternative to traffic school. Learn more on page 8 of the State of the County Health Report.
- Coastal SE United Care: Brunswick County has partnered with Coastal SE United Care to locate a MH/SA provider in Building F of the Government Center campus. Coastal SE takes referrals from jail, court system, and the public.
- Stepping Up Initiative: The goal of the Stepping Up Initiative is to reduce the number of inmates with mental illness in the Brunswick County Detention Center. Staff of various departments work together to identify inmates that can be referred for treatment.
- Brunswick County Opioid Abuse Task Force: The Task Force is comprised of a diversified membership with one goal: reducing the amount of people with opioid addiction. Through a detailed report, it has defined its vision of attacking the opioid abuse problem in Brunswick County.
- Opioid Website: Brunswick County Health Services website provides opioid addiction information; forms of treatment and treatment locator links; current Brunswick County medication and drug overdose data; and additional links to evidence-based initiatives and online services.
- Trillium Access Point: Brunswick County DHHS partnered with Trillium Health Resources to place an Access Point (resource center) in the Department of Social Services that provides customized mental health information, available treatment options, and further recommendations.
- Mental Health First Aid Training: In February 2017, Trillium facilitated Mental Health First Aid training to Brunswick County DHHS employees who may have direct patient or community contact. Learn more on page 9 of the State of the County Health Report.
- North Carolina Department of Health and Human Services (NC DHHS) has launched North Carolina Hepatitis C: Test, Link, Cure (TLC); a program to combat the increasing acute hepatitis C epidemic. The program aims to establish new partnerships with health care providers and stakeholders in North Carolina with a specific focus on hepatitis C screening, testing, prevention education, linkage to care, and treatment. Initial activities will be implemented through local health departments, community based organizations, substance use disorder treatment centers, and federally qualified health centers in the western and southeast coastal regions of the state. In July 2016, the NC DHHS Communicable Disease Branch selected Brunswick County and other Region 8 counties to start hepatitis C testing at the NC State Lab. Free testing is available for baby boomers born between 1945-1965, individuals using injection drugs or having a history of injection drug use, or are HIV infected. Free or low cost treatment is available at two locations in Brunswick County for those with positive test results. Since July 2016, 63 Brunswick County residents met the testing criteria and have been tested by the state lab. To further combat the epidemic, Brunswick County Health Services is planning an outreach event for the Spring of 2018. The initiative includes taking the BCHS mobile unit to various locations throughout the county to offer multiple wellness screenings to residents. Along with hepatitis C screening, BCHS staff and other community partners will also offer hypertension, diabetes, and mental health screenings. Learn more on page 10 of the State of the County Health Report.
Brunswick Health Assessment
Brunswick State of the County Health Report
WIC Program - The Pender County Women’s, Infants, and Children’s (WIC) Supplemental
Nutrition Program served as a pilot county for E-WIC program which began in October 2017.
Electronic automation replaced paper WIC vouchers and has helped the program become more
efficient and consumer/retailer friendly. With the use of a mobile app, clients face less
confusion about WIC-approved food products thus experiencing less stress during the grocery
Opioid Crisis - Following the county commissioners sponsored Opioid Forum, an Opioid Action
Team was established. It is comprised of a variety of public agency leaders that meet on a
monthly basis. The team is working to identify the current strengths, needs and resources
available in the county to address the problems of substance use and addiction. In addition, the
county commissioners approved the hiring of a health educator to assist with research,
identifying best practices, and leading implementation efforts that include preventive education
and increasing community awareness. An epidemic of unintentional poisoning deaths is
affecting southeastern North Carolina counties as well as much of the nation. The vast number
of these deaths are due to misuse/abuse of prescription drugs such as oxycodone and
hydrocodone. These opioid analgesics are involved in more deaths than cocaine and heroin.
Mosquito and Vector Control Program - The health department restructured the county’s
vector program when it was placed under the department’s guidance. Work has begun to utilize
evidence-based processes that will allow for less spraying of pesticides with a focus on homeowner education and prevention activities. Working with Eastern Carolina University and the
N.C DPH Vector Control programs, research activity continues related to the trapping and
identification of mosquitoes. This allows state and local staff to learn more about the types of
mosquitoes in Pender County, including those that carry vector-borne diseases such as the Zika
Virus, Eastern Equine Encephalitis, and Chikungunya.
Safe Drinking Water - In June 2017, a potential toxin, GenX, was identified in the Cape Fear
River. The river serves as a water source for many counties in the southeastern region of the
state. Pender County began processing water from the Cape Fear about six years ago. A risk
threshold of 140 parts per trillion was established as there were no parameters for the perfluorinated compound. Pender County’s processed water regularly tests below the threshold.
Much research has been conducted by the state and federal environmental health divisions.
The county commissioners, health department and county utilities staff remain vigilant,
participating in meetings, regular dialogue among the region, and keeping the community
informed as they are made aware of any updates or identified concerns. The county website is
kept current in order to keep county residents informed of the most recent events.
Public Health 3.0 - The newest initiative for local public health has been launched by the U.S.
Department of Health and Human Services. Earlier versions focused on medical care,
sanitation and agency capacity. The 3.0 version goes beyond traditional public health to
engaging community partners and working to improve social determinants of health. Pender
County Health Department staff has been working with community partners for many years.
However, improving social determinants of health such as conditions in which people are born,
grow, live, work and age will be challenging and require dedicated community support over a
long period of time.
Pender County Health Assessment (2018)
Pender County Health Assessment (2014)
Pender County State of the County Health Report (2017)